ArticleArchives of sexual behavior2025
Condomless Sex and Correlates Among Africans in China: A Nationwide Cross-Sectional Study Based on Egocentric Network Data.
Article in Archives of sexual behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
African migrants in China are at increased risk of HIV and other STDs. Consistent condom use is the most effective and cost-efficient method of preventing STD/HIV. However, there is limited literature on condom use and its determinants among Africans in China. A national online cross-sectional survey was conducted among Africans in China from January to February 2021. Participants completed a survey including social-demographic characteristics, sexual behaviors, and personal networks. Multivariable logistic regression was conducted to identify factors associated with condomless sex. The study surveyed 1305 individuals, with 488 reporting sexual activity and being included in the analysis. Most were young, unmarried, Christian, migrants for study or business in China for over a year, insured, and about half proficient in Mandarin. Notably, 53% reported engaging in condomless sex. Among them, African migrants with low sexual health community engagement (80%), lacking condom distribution services (almost 70%), had an average of 5.61 friends. Multivariable logistic regression analysis revealed higher odds of condomless sex for seven variables: those migrating for study (adjusted odds ratio [aOR] 1.62, 95% confidence intervals [CI] 1.10-2.40), frequent contact with Chinese friends (aOR 1.71, 1.05-2.78), meeting more than one friend on social apps (aOR 1.57, 1.09-2.28), using social apps in China (aOR 2.19, 1.18-4.08), having over three regular partners (aOR 2.41, 1.02-5.69), using alcohol in the past 12 months (aOR 2.13, 1.45-3.11), and alcohol before/during sex in the past 6 months (aOR 2.16, 1.46-3.21). Our data suggest the need for comprehensive sexual health services that are tailored for African migrants in China. Expansion of condom distribution alongside community engagement and decentralized sexual health services based on personal networks is urgently needed among this population.
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